Introduction: Designed in response circumferential lower body lifts (LBL) failure to deepen waists, oblique flankplasty with lipoabdominoplasty (OFLA) not only aesthetically reshapes the waist, but also the hips, buttocks, and upper lateral thighs with minimal morbidity.

Methods: OFLA technique was standardized with 3 of 53 cases presented. Clinical records of operations on the lower torso from March 2000 to January 2018 yielded 30 initial OFLA cases, and hundreds of LBLs. Read More

Background: The gluteal lift ("Brazilian butt lift") has improved significantly in technique and in outcomes. Some postulate that fat embolism occurs because of damage to veins superficial to the gluteus muscles and that fat must be injected intramuscularly to achieve satisfactory aesthetic results. The purpose of this article is to present data where gluteal lift is performed under local anesthesia, address safety concerns, and clarify these speculations. Read More

Authors:

There are some precise rules to succeed with a buttock lift. The article begins with a reminder about the ideal buttock shape. It explains the different quality of skin that is essential to be aware of at the back part of the body. Read More

Background: As buttocks region is one of the most characteristic features of the ideal female body figure, the popularity of gluteal region contouring is on the rise. Perception of body form is influenced by its shape and size. Interventions to modify the form of this region are often difficult due to influence. Read More

Authors:

Mérida, Yucatán; and Zapopan and Puerto Vallarta, Jalisco, México; and Bucaramanga and Bogota, Colombia From private practice; the Divisions of Plastic Surgery and Internal Medicine, Jalisco Institute of Reconstructive Surgery "Dr. José Guerrerosantoss"; the Jalisco College of Plastic, Esthetic and Reconstructive Surgery; Clínica "El Pinar," National University of Colombia, and the National Institute of Legal Medicine and Forensic Sciences Regional Colombia.

Background: Deaths secondary to gluteal lipoinjection are relatively recent events of major importance. However, little is known in relation to their behavior and clinical evolution. Therefore, an analysis was performed of case records from clinical cases that encountered this problem, correlating the results with the findings during autopsies. Read More

Authors:

According to recent data, augmentation gluteoplasty continues to gain popularity in the United States and globally, especially in procedures involving fat grafts. However, serious concerns about its safety have been raised over the past 2 years. Will this trend continue or has it already reached its peak? The answer depends on how the technique is going to be performed hereafter. Read More

Introduction: Abdominoplasty is one of the most popular body-contouring procedures. Despite its popularity, classic abdominoplasty is still associated with a significant rate of complaints from patients such as: fullness of flanks and epigastric areas, lack of a posterior lumbar curve, hanging skin over the incision line, and visible scars over the flanks and beyond underwear or swimming suit coverage. This study reviews the authors' experience in redo abdominoplasty when the patient is not or partially satisfied with the primary procedure. Read More

Even after long-term hormone therapy, many transwomen still have challenges in the size and shape of their breasts and also of the contour of their trunk areas. Though distinct anthropomorphic differences in skeletal structure exist and pose limitations to an ideal result, considerable improvements can be obtained through breast augmentation and trunk feminization. There are challenges that are unique to the transfeminine chest and trunk, and important considerations for the priority of fat grafting to the buttocks and hips when grafted fat is in short supply. Read More

Authors:

Background: As interest in posterior body contour has increased, there has been an upward trend in the number of gluteal augmentations performed. However, there has also been a proportional increase in postoperative complications and subsequent revision operations. Nevertheless, there are currently few studies or reports on secondary gluteal augmentation. Read More

Authors:

Gluteal augmentation with autologous fat transfer is an increasingly popular procedure that has the ability to transform a patient's entire body silhouette and gluteal appearance. Proper patient selection, preoperative evaluation, and planning are critical to the success of the procedure. Using the preoperative planning, surgical technique, and postoperative care described, the procedure can be performed safely with powerful and consistent results and avoidance of complications associated with gluteal fat transfer. Read More

Submuscular gluteal augmentation is a very valid plane for buttocks implantation, even more so in North America, where surgeons can only use silicone elastomer implants. Irrespective of how soft elastomer implants are made, they are much firmer than the silicone gel implants that can be used in other countries. A deeper plane with more soft tissue coverage provides more natural results, as long as the anatomic boundaries are respected. Read More

Authors:

Despite the acceptance of gluteal augmentation procedures into today's mainstream of plastic surgery procedures, clinical anatomy continues to play a critical role in improving outcomes in aesthetic gluteal contouring. In this rapidly growing and evolving field, avoiding complications is imperative for the continuing advancement and acceptance of this group of procedures into the armamentarium of every plastic surgeon. This article highlights the clinically relevant anatomy important to improving patient satisfaction and avoiding complications. Read More

Authors:

Miami, Fla. From private practice and the University of Miami School of Medicine.

Dr. Constantino Mendieta demonstrates and details his personal technique for gluteal augmentation. The video demonstration is divided into three parts: Part I, Aesthetic Analysis and Preoperative Marking; Part II, Creating the Female Silhouette with Circumferential Lipoplasty; and Part III, Autogenous Gluteal Augmentation. Read More

Background: Liposuction and gluteal lipoinjection are two of the most frequent surgical procedures in body contouring surgery, and two of the most important complications are microscopic (MIFE) and macroscopic (MAFE) fat embolism. Despite a high index of morbidity and mortality, few reports exist about these complications, and although they have the same causal agent, their etiopathogenesis, clinical evolution, treatment, prognosis, and prevention are totally different. Therefore, the authors performed a comprehensive review of the literature to exhaustively analyze both pathologic conditions and present the differences between them. Read More

Background: Recent systematic reviews have identified that current patient-reported outcome instruments have content limitations when used to measure change following bariatric surgery. The aim of this study was to measure change after bariatric surgery using the BODY-Q, a PRO instrument designed for weight loss and body contouring.

Methods: The BODY-Q is composed of 18 independently functioning scales and an obesity-specific symptom checklist that measure appearance, health-related quality of life (HR-QOL) and experience of health-care. Read More

Background: An often-neglected part of the lower body lift procedure is the gluteal region. The objective of this study was to classify massive weight loss patients undergoing a body lift procedure and provide a safe, standardized approach for gluteal augmentation.

Methods: A retrospective review of all body lift procedures performed between January of 2012 and January of 2017 was conducted. Read More

The increase in the number of patients who undergo massive weight loss surgery has led to an increasing number of patients who complain of circumferential abdominal skin and soft tissue excess. Currently, the only surgical option to treat soft tissue excess is vertical median abdominal lipectomy (fleur-de-lys technique). However, many patients are reluctant to undergo this surgery because of the position of the scar. Read More

Introduction: There is a growing demand for weight loss sequelae. Some women have a particular morphology with a major trochanteric excess that warrants specific treatment.

Materials And Methods: On the basis of the technique published in 1964 by Pitanguy, the authors suggest a lift of the external face of the thigh with the scar redrawing the lower part of the buttock, from the gluteal fold to the inguinal region by crossing the trochanteric region. Read More

Mycobacterium chelonae is a nontuberculous mycobacterium, classified as a Runyon type IV mycobacterium. In relation to humans, it is most commonly associated with tissue trauma or pulmonary infections. The majority of medical reports describe finding M. Read More

Introduction: Liposuction is a popular surgical procedure. As in any surgery, there are risks and complications, especially when combined with fat injection. Case reports of fat embolism have described a possible explanation as the puncture and tear of gluteal vessels during the procedure, especially when a deep injection is planned. Read More

Authors:

Background: Gluteal fat grafting is among the fastest growing aesthetic procedures in the United States and around the world. Given numerous anecdotal and published reports of fatal and nonfatal pulmonary fat embolism resulting from this procedure, the Aesthetic Surgery Education and Research Foundation (ASERF) formed a Task Force to study this complication.

Objectives: To determine the incidence of fatal and nonfatal pulmonary fat embolism associated with gluteal fat grafting and provide recommendations to decrease the risks of the procedure. Read More

Authors:

Introduction: Patients requesting body-contouring surgery after massive weight loss often present with abdominal and lumbar skin excess as well as gluteal ptosis and loss of gluteal projection. In order to restore gluteal projection a circular abdominoplasty in combination with an autologous gluteal augmentation (all-in-one technique) can be performed.

Objective: To compare outcomes for patients who underwent a circular abdominoplasty with or without autologous gluteal augmentation. Read More

Authors:

From the Department of Surgery, Division of Plastic Surgery, Section of Body Contouring After Weight Loss, University of California Davis, Sacramento, CA.

With the rise in obesity in the United States, there has been a similar increase in bariatric surgery. This has resulted in numerous patients losing significant weight with accompanying circumferential body contouring issues. This has led to an amazing increase in the number of body contouring procedures performed, both traditional excisional techniques as well as new emerging techniques emphasizing tissue preservation, rearrangement, and dermal reshaping. Read More

Background: Increasing obesity prevalence and development of bariatric surgery have led to the development of skin re-draping techniques. Several contouring techniques have been described for treating the circumferential excess of the lower trunk.

Materials And Methods: We performed a systematic review to summarize surgical indications, operative techniques, peri-operative management (nutritional supplementation, antibiotic prophylaxis, thrombo-prophylaxis), outcomes, complications, patient satisfaction, and impact on quality of life of circumferential contouring of the lower trunk procedures. Read More

Authors:

Background And Objectives: Cellulite and lipodystrophy are often found together, especially in areas of the buttocks and thighs, causing skin surface irregularities. Each of these conditions is currently treated independently as two separate surgical procedures. In our practice, we developed a novel combined approach for the simultaneous treatment of cellulite and lipodystrophy, as a single stage procedure in the same anatomic area. Read More

Authors:

Pittsburgh, Pa. From the Hurwitz Center for Plastic Surgery, University of Pittsburgh Medical Center.

Background: After excess skin and fat are removed, a body-lift suture advances skin and suspends ptotic breasts, the mons pubis, and buttocks. For women, the lift includes sculpturing adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin closure to reveal superficial muscular bulk. Read More

Authors:

A 2-position circumferential approach for body contouring of the lower trunk is presented. Mostly indicated in patients after massive weight loss, this approach allows the simultaneous skin resection and reshaping in the abdominal, flank, lateral thigh, back, and gluteal region in the same operation, with only one position change during surgery. Reconstruction of the abdominal wall and gluteal restoration allow volume and shape enhancement with autologous tissue transpositioning. Read More

The primary goal of belt lipectomy surgery is to improve the contour of the inferior truncal circumferential unit and to place the resultant scar in natural junctions. Excessive intra-abdominal content is a contraindication for belt lipectomy. The higher the presenting patient's body mass index (BMI), the higher the risk of postoperative complications and the less impressive the results. Read More

Authors:

Dr Muresan is a resident, Department of Surgery, Union Memorial Hospital in Baltimore, MarylandDr Brownstein is a plastic surgeon in private practice in Berlin, New JerseyDr Shureih is a plastic surgeon in private practice in Baltimore, Maryland

Background: Plastic surgeons are exploring novel techniques for augmentation gluteoplasty as the demand for this procedure increases annually in the United States.

Objectives: The authors retrospectively reviewed a series of lower abdominal dermal-fat graft augmentation gluteoplasties to validate the procedure.

Methods: Nine consecutive patients underwent abdominoplasty or torsoplasty in which 2 oval dermal-fat grafts were excised, de-epithelialized, and then implanted into subfascial gluteal pockets for augmentation. Read More

Objectives: The authors evaluate liposuction as a treatment for patients experiencing complications from silicone injections to the gluteal region, to both preserve aesthetic appearance and minimize further risk of complication from these procedures.

Methods: Eight patients (7 women and 1 man) who presented consecutively to us between 2010 and 2013 with complications from silicone injections to their gluteal region were enrolled in this study. Read More

Background: Stabilized hyaluronic acid (HA) of nonanimal origin manufactured using the patented NASHA® technology has been developed for use in body shaping. This study was performed to assess the safety and efficacy of stabilized HA gel when used for volume restoration and contouring of the buttocks.

Methods: Subjects 20 years of age or older seeking buttock augmentation were recruited to this noncomparative multicenter study (NCT01331408). Read More

Authors:

Philadelphia, Pa. From the Division of Plastic Surgery, Hospital of the University of Pennsylvania.

Background: The purpose of this study was to examine the incidence and predictors of surgical and medical morbidity following body contouring procedures.

Methods: The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2010 for all identifiable body contouring cases including Current Procedural Terminology codes for brachioplasty, medial thigh lift, abdominoplasty, and suction-assisted lipectomy. Independent predictors of morbidity were determined. Read More

Background: The lower body lift (LBL) is a comprehensive body contouring procedure done after massive weight loss. Because of the magnitude of the operation and demands of subsequent care, it has traditionally been viewed as an inpatient procedure. However, it is believed that with surgical experience combined with fine tuning of perioperative and postoperative care, lower body lifting is safe as an outpatient in properly selected patients. Read More

Objective: To analyze a case series of patients who underwent injection of industrial liquid silicone in a clandestine manner and by unauthorized persons.

Methods: We conducted a retrospective analysis of medical records of patients treated between September 2003 and December 2010. Data regarding gender, age, location and volume of silicone injected, time between application and clinical manifestations, complications, treatment and outcome were collected. Read More

Introduction: Deep inferior epigastric perforator (DIEP) flap is one of the gold standards in autologous breast reconstruction. When the abdominal tissue is not available, the superior gluteal artery perforator (SGAP) is often a second option with its drawback, especially the donor-site deformity. Reports have highlighted that a higher and more lateral SGAP flap can be harvested to overcome several drawbacks of the classical SGAP, allowing in the same procedure a body-contouring procedure. Read More

The past 20 years has seen a doubling in the worldwide prevalence of morbid obesity (usually defined as a body mass index BMI, >40 kg/m(2)). Scotland has one of the worst obesity records amongst developed countries. In 2010, 65. Read More

Authors:

Department of Plastic and Reconstructive Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.

Massive weight loss results in skin excess, leading to an unsatisfying body contour. Various thigh lift procedures can correct flabby skin in the lower leg. We present a lower body contouring technique with a report on two patients. Read More

Authors:

Techniques for improving the appearance of the gluteal region are important elements in body contouring. In all cultures and communities, this aspect of the physique holds a special place among the elements comprising the ideals of physical beauty. Recent studies described the aesthetics of the gluteal region in terms of shape, volume, and projection. Read More

Authors:

Body contouring after massive weight loss is an important step of the treatment for obese and overweight patients. As a member of the bariatric multidisciplinary team, the plastic surgeon helps to finish the reconstruction process by removing skin and fat excess. With the rise of bariatric surgery and extreme weight loss, this surgery is more in demand and has became more and more performed recently and well codified. Read More

Background: Patients requiring surgical skin excision after massive weight loss are challenging and require a structured approach. The characteristic abdominal deformity includes a draping apron of panniculus, often extending to the glutaeal, back and thigh areas. Occasionally, these deformities are associated with previous surgical scars in the upper abdomen resulting from open gastric bypass surgery or from other procedures, such as open cholecystectomy. Read More

Background: Unlike traditional plastic surgery patients who present with a specific anatomical complaint, massive weight loss patients often have multiple regions of concern. No single procedure can address the whole-body deformities associated with massive weight loss. The authors sought to quantify their clinical experience to provide evidence-based analysis of procedural combination in body contouring. Read More

Background: Aesthetic surgery of the thoracoabdominal region is one of the most frequently performed surgical procedures in plastic surgery. The combination of circumferential liposuction, autologous fat grafting of the buttocks and/or lower limbs, and the modified transverse abdominoplasty as an adjuvant procedure all done in a single surgical procedure is not very common. The authors present a prospective study of the surgical technique of composite body contouring, emphasizing the low rate of complications and the high overall patient satisfaction. Read More

Authors:

Abdominoplasty is a very common procedure, especially for patients with abdominal laxness, striaes, and muscle rectus diastases. With the advent of liposuction 28 years ago, we can improve body contouring by treating lipodystrophies in the epigastric, flank, trochanteric, and buttocks areas. The procedure combining abdominoplasty and liposuction is called lipoabdominoplasty. Read More

With the advent of bariatric surgery, body contouring has grown to a new speciality in plastic surgery. Following massive weight loss, patients generally have skin redundancy on the trunk, buttocks, breast, upper arms, thighs and face, leading to a poor quality of life and social acceptance. This condition motivates many patients to consult a plastic surgeon to address these problems. Read More

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